Getting high!

With the legalization of marijuana just around the corner, or already there, I thought I should write about getting high. Perhaps cannabis is a cure for altitude sickness, or perhaps one just wouldn’t care if he or she has a splitting headache and is vomiting incessantly on Kilimanjaro! The following is what I give to my patients. I hope you find it useful. Please refer to the links at the end.

The High Altitude Handout

Congratulations. You are about to get high! Here is some information regarding altitude sickness (AS).

How quickly you go high (are you flying to 12,000 feet or going by bus over a few days)

How well hydrated and warm you stay

The amount of exertion involved (i.e hiking vs taking the train)

Luck, or your personal predisposition – those who have had AS in the past are more prone; age and fitness have little to do with it

Most people will feel a bit unwell – short of breath with exertion, lightheadedness, loss of appetite at high altitudes. This should go away within a few days. Some people also experience “periodic breathing”, or trouble catching your breath at night. The types of altitude sickness include:

Acute mountain sickness (AMS) – headache, nausea, vomiting – usually beginning usually within 24 hours of arriving at your new altitude. Sounds a bit like a hangover!

If left untreated or if one continues to ascend with symptoms …

High altitude pulmonary edema (HAPE) – shortness of breath at rest, trouble lying down flat, cough and blood tinged sputum … this can be fatal!!!

To minimize your risk of getting AS, either mild or severe, consider the following:

Getting to your destination gradually is preferable to suddenly flying to a high altitude. One does not always have this option!

Taking it easy when you reach your high altitude …. consider sightseeing around Cuzco for a day or two before you hike the Inca Trail. On your trek, go slow…go slow…go slow!

Drink lots of water (preferably clean water!)

Consider the local remedies such as coca tea in The Andes or garlic soup in Nepal.

Keep warm.

Limit the change in your sleeping altitude to no more than 1,500 feet per day, and consider a day of rest every 3-4 days (applies to longer treks in Nepal)

Don’t continue to ascend with symptoms of AMS. Descend if you are very sick or not getting better.

Take along Diamox (acetazolamide) to use either preventatively (start the day before ascent) or if needed. It has three side effects – you will pee more often, you might experience some tingling in your hands, feet and around your mouth, and carbonated drinks might taste funny… It may be used just for the first few days, or continuously if you continue to climb higher.

Other meds, such as Decadron (steroids, for HACE) and Zofran (an antinauseant) and nifedipine (Adalat) (for HAPE) should be reserved for the minority of climbers on more dangerous expeditions, or those who are medically responsible for others.